Judge M. Yvette Miller. (Photo: John Disney/ALM)

A splintered Georgia Court of Appeals panel allowed a group of former patients challenging medical liens levied by the Columbus Medical Center to retain the class status granted by a trial judge, with one judge dissenting and another concurring in judgment only.

The court also upheld the decision by a Muscogee County judge denying summary judgment to the hospital.       

The ruling was hailed by Bondurant, Mixson & Elmore partner Michael Terry, who represents the putative class members with firm colleagues Frank Lowrey IV and Michael Baumrind, and Charlie Gower and Charles Gower Jr. of Columbus' Charles A. Gower P.C.

“We appreciate the Court of Appeals' careful consideration of the important issues in this case,” said Terry, noting the case has been pending since 2012.

“With both certification of the class and denial of summary judgment now affirmed on appeal, we look forward to a prompt trial,” Terry added.

The Medical Center is represented by Paul Ivey Jr., Roger Calhoun Jr. and Lauren Dimitri of Hall Booth Smith's Columbus office, and Troutman Sanders partners Lindsey Mann and William Withrow Jr.

They did not respond to requests for comment, but the fractured ruling may set the stage for further adjudication in a case that has already traveled to the Court of Appeals and Georgia Supreme Court on other issues.

As detailed in the Nov. 1 opinion and other filings, the case began with a 2011 auto accident involving an Enterprise rental car and uninsured passenger Danielle Bowden, then 21, who was injured and taken by ambulance to the medical center.

The medical center billed Bowden $24,409 for her treatment and filed a medical lien against her for that amount that would attach to any recovery she might receive as a result of her injuries.

In 2012, Enterprise offered Bowden its $25,000 policy limits to settle any claims against it, filing an interpleader action and paying that amount to the court registry.

Bowden filed a cross-claim against the the medical center, challenging its lien as grossly excessive and not reflective of the actual value of care she received. In a footnote, the opinion notes that the medical center offered to accept $8,333 to settle its claim, but Bowden refused.

Bowden's claims against the center included unjust enrichment, breach of contract, fraud, negligent misrepresentation, racketeering and deceptive trade practices.

A discovery battle over the center's billing rates and practices led to the Court of Appeals, which deemed the evidence sought irrelevant, an opinion the high court reversed in 2015.

Back in Muscogee County Superior Court, Bowden amended her complaint and sought class status, adding claims by three other medical center patients who had been uninsured, injured in auto accidents and subject to hospital liens.

After hearing testimony from the plaintiffs' expert witness, Judge Maureen Gottfried granted the class certification and denied the hospital's motion for summary judgment. The hospital appealed both rulings.  

The majority opinion affirmed the bulk of Gottfried's orders, although it agreed with the medical center that the racketeering and deceptive trade practices claims should have been dismissed.  

Presiding Judge Yvette Miller wrote the opinion with a concurrence in judgment only by Judge E. Trenton Brown III and a partial dissent by Judge Steve Goss.

Miller's opinion said that Gottfried did not abuse her discretion in allowing expert testimony on the reasonableness of the hospital's rate and rejected the hospital's argument that the proposed class failed to satisfy the numerosity, typicality and other requirements of Georgia's class action statute.

But, Miller wrote, Bowden had estimated that the number of patients potentially impacted by the medical center's liens could be in the thousands and had submitted evidence of 267 liens in their motion for certification.

“The fact that some of these class members might be entitled to fewer damages than others does not defeat class certification,” Miller wrote.

In any case, she said, “if, after further discovery, it becomes clear that class status is unmanageable, or that fewer persons than initially anticipated constitute the class, the trial court can modify the class or decertify it as necessary.”

As to the similarity of the claims, Miller said, the trial court had identified several areas of commonality among the proposed class and the rates set by the hospital's cost list, or “chargemaster.”

“The common question applicable to all class members is whether the chargemaster rate, which universally served as the basis for the lien amount, was reasonable,” the opinion said. “There is evidence that it would be possible to determine a common answer that does not require individualized analysis.”

The proposed members also satisfied the law's typicality requirement, Miller said, “in that all were uninsured, all were injured due to a third-party tortfeasor, and the hospital filed a lien against all for non-payment of bills at the full chargemaster rate.”

Gottfried did not abuse her discretion in certifying the class, the opinion said.

”Here, the trial court found, and we agree, that common issues predominated because [the medical center's] conduct was a repeated demonstration of allegedly unfair conduct in the same manner against every member of the class.”

Goss wrote separately that he did not agree the class should have been certified, because the commonality requirement was not met.

While the trial judge certified the class as anyone who had a lien filed against them in excess of what a “reasonable” charge would be, Goss wrote, such considerations must include the individual circumstances of each case, when the care was provided and what it cost the hospital.

“Our Supreme Court has also noted that the patient against whom a lien is filed need not be responsible for a hospital lien in order for the lienholder hospital to foreclose on that lien as against 'some other person or entity[,]' such as the the third-party insurers involved here,” wrote Goss.

“In other words, a patient against whom a lien is filed may never have to pay a penny of that lien.”